title: Fat grafts supplemented with adipose-derived stromal cells in the rehabilitation of patients with craniofacial microsomia.
abstract: BACKGROUND
  Although first reports of the clinical use of adipose-derived stromal cells suggest that this approach may be feasible and effective for soft-tissue augmentation, there is a lack of randomized, controlled clinical trials in the literature. Thus, this study aimed to investigate whether a faster protocol for isolation of adipose-derived stromal cells and their use in combination with fat tissue improve the long-term retention of the grafts in patients with craniofacial microsomia.
  
  
  METHODS
  Patients with craniofacial microsomia (n = 14) were grafted either with supplementation of adipose-derived stromal cells (experimental group) or without supplementation of adipose-derived stromal cells (control group). The number of viable cells isolated before and after the supplementation of the grafts was calculated, and these cells were examined for mesenchymal cell surface markers using flow cytometry. Computed tomography was performed to assess both hemifaces preoperatively and at 6 months postoperatively.
  
  
  RESULTS
  The average number of viable cells isolated before and after the supplementation of the grafts was 5.6 × 10 and 9.9 × 10 cells/ml of fat tissue (p = 0.015). Flow cytometric analysis revealed that the adipose-derived stromal cells were positive for mesenchymal cell markers (>95 percent for CD73 and CD105). Surviving fat volume at 6 months was 88 percent for the experimental group and 54 percent for the control group (p = 0.003).
  
  
  CONCLUSIONS
  These results suggest that this strategy for isolation and supplementation of adipose-derived stromal cells is effective, safe, and superior to conventional lipoinjection for facial recontouring in patients with craniofacial microsomia.
  
  
  METHODS
  Therapeutic, II.
authors.affiliation: São Paulo, Brazil From the Division of Plastic and Reconstructive Surgery, University of São Paulo School of Medicine; and the Human Genome Research Center, Institute of Biosciences, University of São Paulo.
authors.forename: Daniela Y S
authors.initials: DYS
authors.lastname: Tanikawa
authors.forename: Meire
authors.initials: M
authors.lastname: Aguena
authors.forename: Daniela F
authors.initials: DF
authors.lastname: Bueno
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Passos-Bueno
authors.forename: Nivaldo
authors.initials: N
authors.lastname: Alonso
mesh_terms: D000273:Adipose Tissue / Q000166:cytology*; D000293:Adolescent; D002648:Child; D019465:Craniofacial Abnormalities / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000379:methods*; D017154:Stromal Cells / Q000637:transplantation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome